Feb. 26 (UPI) -- The American Academy of Pediatrics has issued updated guidelines that call for yearly depression screening for all adolescents.
In an effort to assist primary care doctors, the American Academy of Pediatrics recommends depression screening for all children between ages 12 and 21. The U.S. Preventive Services Task Force earlier recommended that youths 12-18 undergo screening for major depressive disorder.
Currently, about 50 percent of adolescents with depression are diagnosed before reaching adulthood and as many as 2 in 3 depressed teens don't get care, according the AAP.
"It's a huge problem," Dr. Rachel Zuckerbrot, a psychiatrist and associate professor at Columbia University who helped write the guidelines, told NPR.
The guidelines, according to AAP, are intended to assist primary care "clinicians in the identification and initial management of adolescents with depression in an era of great clinical need and shortage of mental health specialists, but they cannot replace clinical judgment. ... Additional research that addresses the identification and initial management of youth with depression in PC is needed, including empirical testing of these guidelines."
In the first update of guidelines in 10 years, pediatricians are encouraged to talk to their young patients alone.
"So many teens don't have access to mental health care," family psychologist Dr. Jennifer Hartstein told NBC's Today. "It has to start with their pediatrician, and these changes really point in that direction."
Zuckerbrot said that screenings can be performed during well-visits, sports physicals or during another office visit.
Hartstein said the test will "will be be more than just 'I feel sad on a scale of 1 to 5,' it'll be much more detailed, and ask for more situational and informational stuff, so that we can be much more specific in our diagnosis."
Most pediatricians use a self-reported questionnaire for teens to fill out, including information on whether or how often they are feeling down, depressed or hopeless and whether they have little interest or pleasure in doing things. Sleep patterns are also examined.
"Teenagers are often more honest when they're not looking somebody in the face who's asking questions" about their emotional health, Zuckerbrot said.
"It's an opportunity for the adolescent to answer questions about themselves privately."
Kaiser Permanente in Colorado has developed a stigma-reduction campaign called Find Your Words.
"Stigma is a huge challenge, specifically for adolescents," Dr. Doug Newton, a child psychiatrist at Kaiser Permanente, told NPR. "Often times they're not coming in to get help because of the stigma attached."
Depression can lead to suicide, which is the second-leading cause of death for children aged 10 to 24 behind unintentional injury, according to the Centers for Disease Control and Prevention.
"Adolescents are at particular developmental risk, as this period is marked by a search for identity and independence, accompanied with emotional characteristics including curiosity, strong peer influences, immaturity, and mood swings," the AAP wrote. "Each of these ordinary developmental stages and experiences put young people at a greater risk for impulsive and sometimes violent action, particularly for adolescents with a history of aggressive and violent behaviors, suicide attempts or depression."
The AAP wrote that that "adolescent suicide risk is strongly associated with firearm availability" and families with a depressed teen are urged to keep firearms away from them.